HomeMy WebLinkAboutPermit Electrical 2011-8-23
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Electrical Permit Application
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CITY OF SPRINGFIELD, OREGON,
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225 I<'ifth Street. Springfield. OR 97477. PII(541)726-3753. "'AX(54t)726-3689
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: DEPARTMENT USE'ONIlY
Permit no.: 5//-0 / g I J
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Date:
This permit is issued under OAR 918~309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? DYes D No
CATEGORY OF CONSTRUCTION
Commercial
7
Name:
Address:
Phone:
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family. This
property is not intended for sale. exchange, lease, or rent. OAR
479.540(1) and 479.560(1).
Signature:
E-mail:
CCB license no.: L
BCD license no.<(
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Signing supervisor's license no.;
Signature of signing supervisor
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'.. FEE SCHEDULE
Number oLinspec,tions per item (t Qty, Cost Total
ea. cost
Residential, per unit, service included:
1,000 sq. n. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
lhereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Sen.'ices or feeders: ins/allation, alteration, relocation
200 amps or less (2) $ 81.00 $
20110400 amps (2) $ 95.00 $
40 I to 600 amps (2) $158.00 $
601 to 1,000 amps (2) $205.00 $
Over 1,000 amps or valls (2) $469.00 $
Reconnect only (2) $ 63.00 $
Temporary services or feeders: installation, alferation, relocation
200 amps or less (2) $ 63.00 $
20 I to 400 amps (2) $ 87.00 $
401'0600 amps (2) $126,00 $
Over 600 amps or 1,000 volts, see services or feeders section above
Branch circuits: new, aI/era/ion, extension per panel
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit I $ 6.00 $
b. Fce for branch circuits without purchase of a service or fceder fee:
First branch circuit (2) I $ 55.00 $ ~< .
Each additional branch circuit 10 $ 6,00 $..G k>
Miscellaneous fees: service or feeder not included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63,00 $
Signal circuit or a limited-energy panel. $ 63.00 $
alteration, or extension (2)
Each additional inspection: (I) $58.00 $
: . APPLICANT USE ,
(A) Enter subtotal of above fees $/(S
(J\linimurn Permit Fee $58.00)
(B) Enter 12% surcharge (.12, IA]) $ 1':5. D'
(C) Technology Fee (5% aflAIl $ S",l
].!?:':.A~ fees and surcharges (A ~hraugh.C): $ I?C/S
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ATTENTION: Oregon law requires you to ~ \ \\
follow rules adopted by the Oregon Utility l\ t><..'
Notification Center. Those rules are set forth6' v~
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by il\ ~
calling the center, (Note: the telephone -(\
number for the Oregon Utility Notification , ~ ri
Center is 1-800-332-2344), "Jl' THIS PERMIT SHAll EXPIRE IF THE WORK
440-2584-J(9/08/COM) AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-5PR2011-01813
1957 Don 5T
permitcenler@ci.springfield.or.us
RECEIPT NO: 2011002299 RECORD NO: 811-SPR2011-01813
lDESCRIP..TION " AC.COUNTj::.ODE
Branch circuits without service or feeder -1st circuit 224-00000-426102
Branch circuits without service or feeder - each additional 224-00000-426102
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004
Technolo~y fee (~% of permit total) 100-00000-425605
TOTAL DUE:
DATE: 08/23/2011
AMOUNT.D.UE
55.00
60.00
13.80
5.75
134.55
AMOUNT PAID.
134.55
LP-AXMENLlY.P-E
Credit Card
099746
. -. P',~y'QR CASHIER: DBOWLSBY
COMPLETE ELECTRICAL INSl
COr:llME,NTS
TOTAL PAID:
134.55